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Interruption of Menstrual Cycle by Chemotherapy Associated with Improved Survival in Early Breast Cancer
Date:6/3/2010

ine responsive breast cancers designed to evaluate the potential benefit of more specific suppression of ovarian function with drugs that inhibit production of the critical pituitary hormones that drive ovarian function. These studies are completing accrual, but results will not be known for several years.

“The new and surprising observation in our study was that chemotherapy-induced amenorrhea was associated with improved survival among premenopausal women with estrogen negative breast cancers as well as those with endocrine responsive breast cancers. This would suggest that the ovaries may be playing an important role beyond estrogen production that is influencing the disease process,” said Dr. Geyer, who also serves as Director of the AGH Cancer Center and Director of Medical Affairs for the NSABP.

As an important secondary endpoint of the trial, the research team prospectively documented menstrual status at baseline and after therapy in premenopausal women in order to assess the effect of amenorrhea on patient outcomes. Both overall survival and disease-free survival were significantly better among patients who had no menstrual activity for at least six months as compared to those who continued with normal menstrual patterns. The results were consistent regardless of age, regimen used and estrogen receptor status.

Dr. Geyer said the finding underscores the need to further study the role of induced amenorrhea, and ultimately to consider a future randomized clinical trial evaluating ovarian suppression as a specific intervention in premenopausal women with estrogen receptor negative breast cancers.

The study’s primary endpoint conclusion, however, could have a more immediate impact on the standard of care, said Norman Wolmark, MD, the paper’s senior author and principal investigator for the National Cancer Institute Grant that funded the research. Dr. Wolmark is Chair of both the NSABP and the D
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